The most common symptoms of oesophageal cancer include: There are many other conditions that cause these symptoms. Most of them are much more common than oesophageal cancer. You should see your
doctor if you have difficulty swallowing, or you have symptoms that are unusual for you or that won't go away. Your symptoms are unlikely to be cancer but it is important to get them checked by a doctor. You may feel pain or a burning sensation when you swallow, or your food may stick in your throat or chest. This is the most common symptom of oesophageal cancer. A harmless narrowing of the oesophagus called a stricture can also
make it difficult for you to swallow. It is important to get this symptom checked by your doctor. You can get indigestion when acid from your stomach goes back up (refluxes) into the oesophagus. Or when the stomach is inflamed or irritated. The valve between the stomach and oesophagus normally stops this from happening. The valve is called the cardiac sphincter. A tumour that develops here can stop the valve working,
causing indigestion. Remember that indigestion is common and it's not usually caused by cancer. It can be very painful, even when there's nothing seriously wrong. See your doctor if you’ve had heartburn most days for 3 weeks or more, even if you’re taking medicine and it seems to help. Heartburn is burning chest pain or discomfort that happens after eating. Weight lossYou may be put off eating if you find it hard to swallow or have pain when you swallow your food. This can make you lose weight. Rarely, extreme weight loss can be a sign of an advanced cancer. Pain in your throat or behind your breastboneYou may feel pain in the centre of your chest, or more rarely in your back or between your shoulder blades. This can get worse when you swallow or have indigestion. Other symptomsOther symptoms can include: Food coming back upYou may regurgitate food – this is when food comes back up soon after you swallow it. It usually starts with food like meat and bread. You may start to bring up soft foods such as mashed potato, drinks and saliva if you don't have treatment. A cough that won't go awayA cough that won't go away or that happens when you try to eat can be caused by oesophageal cancer. HoarsenessYour voice can become raspy or croaky. It's not a common symptom and can be caused by other harmless conditions. Coughing up bloodYou may cough up blood or have blood in your vomit (or food that you bring back up) if your oesophagus is bleeding. This isn't common. Dark pooYour poo may be darker – almost black – if cancer is making your oesophagus bleed. This is uncommon. You can get darker poo if you're taking iron tablets. You may never have heard of a rare condition called “nutcracker esophagus” or “jackhammer esophagus.” Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy Many doctors are unfamiliar with it, too. That’s why the frequently painful condition with the colorful name often goes undetected. “Nutcracker esophagus” can trigger chest pain, difficulty swallowing and the feeling that food is getting stuck,” notes gastroenterologist Scott Gabbard, MD. “It’s often misdiagnosed as a heart attack or acid reflux.” How swallowing is affectedNutcracker or jackhammer esophagus targets the smooth muscles that usually move food seamlessly from your throat down to your stomach. So does esophageal spasm. “Think of these disorders as cousins,” says Dr. Gabbard. “Normally, when you swallow liquids or solids, there’s a nice, coordinated squeeze moving from the top, to the middle, to the bottom of the esophagus.” But in jackhammer esophagus, the muscle contractions are too strong. And in esophageal spasm, the muscle contractions are too rapid. New technology, new nameImprovements in manometry, the muscle test used to diagnose both conditions, led to a new name for nutcracker esophagus. Older, 2-D manometry tracings revealed a nutcracker pattern when the esophagus muscles squeeze hard enough to close the esophagus. Newer, 3-D high-resolution manometry tracings instead reveal “a strong, repetitive pattern of contractions that look the pounding of a jackhammer all the way down the esophagus in some patients,” says Dr. Gabbard. Pain variesBoth conditions can cause chest pain severe enough to send you to the emergency room — or no symptoms at all. When patients present with chest pain, doctors first rule out heart disease, he says. Their next step is typically upper endoscopy or prescribing anti-reflux medicine to see if the problem is acid reflux. If pain and swallowing difficulty persist, they often stop there and assume it’s esophageal spasm. “But manometry is the only way to diagnose these muscle disorders,” Dr. Gabbard notes. Four treatmentsOnce jackhammer esophagus or esophageal spasm are diagnosed, treatment involves relaxing the esophagus muscles using: 1. Medication. Calcium channel blockers relax the smooth muscle both in the arteries and in the esophagus. “Taking a calcium channel blocker before eating helps about 75% of patients with swallowing,” says Dr. Gabbard. “But some can’t tolerate the blood pressure medicine.” If pain persists, he will prescribe a tricyclic antidepressant, which targets the esophageal nerves. 2. Peppermint oil. For patients who don’t want to take medication or don’t respond to it, Dr. Gabbard recommends peppermint oil. “About half of those who can’t tolerate blood pressure medicine respond to peppermint oil,” he says. “One study found that it helped esophageal spasm, so it should also help jackhammer esophagus.” 3. Botox®. When medications and peppermint oil don’t help, the next step is botulinum toxin injections. “90% of the time it can stop the jackhammer or spasms, but it only lasts about a year,” notes Dr. Gabbard. 4. POEM. In select cases, when patients who respond only to Botox want a permanent solution, he may recommend a new, minimally invasive procedure called Per Oral Endoscopy Myotomy (POEM). A small incision is made in the esophagus muscle to stop contractions. “POEM is irreversible, so patients no longer have working muscle,” he points out. “But gravity helps them drain food from the esophagus.” Jackhammer esophagus and esophageal spasm may resolve on their own or remain stable. “The good news is that they don’t turn into anything worrisome, like cancer,” he says. Disease can strike anyone“Any patient, from ages 8 to 108, can get these conditions,” says Dr. Gabbard. “But they are somewhat rare, affecting less than 1% of the population.” Chronic use of opiates (to manage cancer pain, for example) can increase risk. And while some patients with acid reflux develop jackhammer esophagus or esophageal spasm, most do not. If you have chest pain, it’s imperative to rule out a cardiac cause, Dr. Gabbard stresses. “But if chest pain and swallowing do not improve after endoscopy, be proactive,” he says. “Tell your doctor what’s going on. Ask for manometry.” How do I stop my chest from hurting when I swallow?proton pump inhibitors, which block the production of stomach acid. medications to help relax the muscles of your esophagus, such as nitrates or calcium channel blockers. steroid medication to treat inflammation associated with esophagitis. tricyclic antidepressants to help ease pain in the esophagus.
Why does it feel like there is something stuck in my chest when I swallow?Esophageal dysphagia. Esophageal dysphagia refers to the sensation of food sticking or getting caught in the base of your throat or in your chest after you've started to swallow. Some of the causes of esophageal dysphagia include: Achalasia.
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When you swallow and it hurts in your chest
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